Thriving in third-year clerkships: Learning medicine at the bedside

Third year is an exciting turning point in medical school. After two years of learning the information necessary to pass classes and the first COMLEX exam, it is time to apply all that knowledge and skills in clerkship. However, when a pandemic threw a curveball to medical education, the osteopathic medical students in the Class of 2023 adjusted to both virtual and in-person rotations.  

Moving for clinical rotations

Kevin Chen, OMS IV, of Kansas City University College of Osteopathic Medicine (KCU-COM), had to move from his pre-clerkship campus to his base hospital, like many osteopathic medical students.

“I moved from Kansas City to Metro Detroit. My best advice is to find a place that is close to the hospital so you can spend less time commuting. Keep in mind that some rotations start very early, like general surgery, and that extra sleep is priceless. Home should be a relaxing place for you to enjoy, so find a place that you like and can unwind after a long day,” Chen said.

How the COVID-19 pandemic affected clinical rotations

By the time Jose Parra, OMS IV, of Touro University Nevada College of Osteopathic Medicine (TUNCOM), started clinical rotations, vaccines were readily available and most rotation sites in the area were willing to take on students.

“I only had one virtual clerkship for surgery, however, once the year progressed, I was able to gain more in-person surgical experience within my elective months,” Parra shared. “It ultimately worked out in the end!”

While the ebb and flow of COVID-19 spikes caused many elective surgeries to be postponed and med-surg floors to be converted into COVID units, Chen felt that his base hospital did a good job providing adequate PPE and supplies. “Our residents and attendings wanted to prevent us from unnecessary COVID exposures,” he said.

Making the most out of each experience

“Work hard and study for each clerkship as if that was the specialty I was going into,” was the advice given to Parra by senior classmates.

“Having this kind of mentality gave me the opportunity to do and learn even more clinically than I expected. My preceptors appreciated my willingness to learn as much as I could,” said Parra.

Chen recommends setting goals for yourself in what you hope to learn out of each clerkship, “Whether it is learning how to suture or obtaining psych histories, third year is the only time where you can explore. You made it this far – sometimes it is hard to remember that you are now part of the care team. Enjoy being a physician-in-training. Your clinical skills will improve over time. Practice gathering patient histories and get comfortable with physical exams.”

Adapting your learning strategy

Transitioning from studying at your own pace and schedule in preclerkship to working a full-time shift while still being expected to study for the COMAT exams in clerkship can be a challenge. Efficiency is important with clinical rotations.

Parra shared: “I quickly learned that I needed to drive to a coffee shop after my shift and knock out some UWorld questions. On my downtime in clinic, I would read up on relevant topics. It is a bit of a shift, and you play catch-up a bit more on your off days, but it is totally manageable!” He emphasizes that time management is of the utmost importance and resources like Cramfighter helped him organize his study routine.

Chen suggests seeking online resources like OnlineMedEd to help learn clinical knowledge, while question banks will help reinforce knowledge. There is a lot of hands-on learning on rotations. “While on the wards, there will be days where you will feel like you do not know anything, and that is OK. Be eager to learn and ask questions,” said Chen.

Enjoy this year!

Chen and Parra agree that practicing work-life balance and self-care is important during this year.

“Make sure you always spend some time on self-care, whether that is relaxing with a movie or taking time to exercise. Sleep enough every night,” said Chen.

You have to take care of you, Parra notes.

“Be sure and get a good workout in and have some dedicated time for yourself,” said Parra.

He also shared that extracurriculars are very manageable during this year. He was involved with the Council of Osteopathic Student Government Presidents (COSGP). He encourages incoming OMS IIIs by saying, “You must really set some firm boundaries with yourself and be willing to make mistakes, it is how we learn!”

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